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South Dakota rates for HCPCS 50920

Closure of ureterocutaneous fistula

Facilitymedian $1,148 · 10th–90th $832–$4,3650%20%10th90th$1,148Professionalmedian $1,122 · 10th–90th $832–$2,3440%10%20%10th90th$1,122$1.0K$2.0K$5.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$831.76 / $831.76 / $4,365.16
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $891.25 / $1,122.02
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,905.46 / $2,041.74 / $2,511.89
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,548.82 / $2,290.87
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$812.83 / $1,584.89 / $6,606.93
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,819.70 / $1,905.46 / $2,041.74
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,819.70 / $1,819.70 / $1,819.70
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,148.15 / $1,479.11 / $1,698.24
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,995.26 / $1,995.26 / $1,995.26
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$891.25 / $1,737.80 / $2,454.71
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,698.24 / $1,995.26 / $2,089.30